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The most important consideration for staff meetings is that they actually happen - and often! My preference is for weekly meetings but I find that many practices don't hold them that frequently. Indeed, many practices hardly ever have staff meetings! I think that's a mistake because so much of practice success can be traced back to staff issues.

To build the successful practice, we need a staff that is top notch in all aspects of the job, from the technical aspects to customer service. I've yet to see a staff that is perfect and staff meetings are a key factor in bringing employees to a higher level of performance. An important role of the practice owner, doctor and manager is to continually lead, inspire and train staff members. Over time, the improvement is obvious and dramatic.

How to start

I like to keep things simple to increase the likelihood that the meetings will occur every week. Keeping things simple also reduces any perception that the meeting is formal and intimidating. The casual approach makes employees more comfortable and willing to speak up.

Start by blocking out the appointment schedule for the meeting on the same day and time every week for months in advance. I prefer to hold meetings during normal business hours because I don't like to ask employees to come early or stay late. I don't want the tone of the meeting to be such that employees are doing me a favor by attending. Of course, employees are paid for their time spent in the meeting. Once the schedule is blocked from appointments, the meetings are likely occur.

It doesn't matter if you have one employee or 50, weekly staff meetings are critical for success.

There is no one right way to manage a staff meeting so just do what comes naturally and feels right. Here are some ideas to consider.

When to hold the meeting

A good time for the meeting is first thing in the morning for one hour (9 to 10am). This time slot prevents problems if the office is running late or extra busy and staff can't attend. Lunchtime could work, but I don't like employees to have to work during their lunch breaks on a regular basis. The end of the day is not usually the best time because people are tired and want to go home to their families.

Choose a day of the week when most employees are scheduled to work in order to gain maximum attendance; perhaps it can be held on a day with longer office hours.

I don't like to close the office during staff meetings. Having the door locked and voice mail turned on is not patient friendly.

Depending on the number of employees in the practice, it may be smart to break the staff into two groups and hold two separate meetings, so the office can remain open, phones are answered and walk-in dispensing patients are cared for. Typically, the business office attends one meeting and the technicians, opticians and optical lab staff attends the other. All doctors and office managers attend both meetings. Some topics are repeated to both groups and some are specific for one group.

Breaking into two groups may not always work well with special topics or events, so sometimes you may have to select one or two employees to staff the front desk and phones. It's OK to close the office on rare occasions for very important meetings, in which case signs should be posted days in advance of the closing and a specific voice mail announcement should be recorded.

Choose a place in the office that will seat everyone and offers some privacy from patients who drop in.

Keep an eye on the time during the meeting and end early if possible.

Who attends and who does what?

In a group practice, I like the doctors and office manager to meet every morning for 15 minutes before normal business hours. On the day of the staff meeting, the manager shares any issues to be presented at the meeting.

This pre-meeting serves to allow the leaders to brief each other on the topics they would like to bring up. In some cases, the manager may suggest items for the doctor to present. The pre-meeting prevents disagreements at the meeting and gives everyone time to be prepared.

The doctor is a natural to chair the meeting, but should look to involve staff members by asking questions and asking for key people to report on their areas. The office manager is asked to present any issues for discussion. Key staff members should know that they are welcome to bring new items of interest to every meeting. The doctor is the practice leader and employees need to hear from him or her on a regular basis. The doctor's attitude and vision shapes the practice culture.

I don't expect employees who are not scheduled to work to come in for a meeting unless there are special circumstances. Written minutes are kept and absent individuals must read and initial the notes. Minutes are kept in a notebook for future reference.

If an employee or doctor is required for an urgent patient need or phone call, a working staff member should come into the meeting and quietly call him or her out.

Food is generally not provided at most staff meetings, except for coffee and items brought in for all by staff or sales reps. It is not planned for or expected. I find food can be a distraction and the typical meeting is short and to the point.

What to talk about

The doctor and manager should make written notes all week long on problems that are seen that should be discussed at the meeting. Individual problems are best discussed with the employee one-on-one as soon as possible, but many issues should be presented to all staff in a general way.

A printed agenda is usually not needed and nothing is passed out in advance. All employees will be given an opportunity to bring up any issue or topic they wish.

Individuals should never be embarrassed or criticized at a staff meeting. All criticisms and policy issues are presented to the staff as a group. If an employee makes a statement that is not well received by others, the doctor should mitigate the reaction by showing some sign of support - even while correcting the statement.

The doctor should make time for positive remarks about the overall good performance of the staff. Patient survey cards often provide good comments which should be shared.

Some meetings are planned for staff training on specific topics. The doctor or any other expert employee will make the training presentation. Hands-on practice is encouraged when appropriate. Written handouts should be used whenever possible.

The doctor may invite an outside sales rep to speak at some meetings, but this should be done rarely and only when an important message is delivered. Realize that many reps are well-intentioned but poor speakers and the talk could be boring and may present ideas that are not in agreement with the practice owner. Always screen the rep in advance for time and insist that the talks be kept very brief.

In the absence of enough topics, the meeting may be adjourned early to allow employees time to work before patients arrive. One excellent approach when time permits is to ask employees - Tell us about something you've seen in your area lately that has made patients unhappy. The discussion that ensues is always valuable.

The doctor should not feel pressured to fix all problems during the meeting. It is often smart to respond that you will look into an issue further and respond in the near future. Be sure to make note of it and follow through.

The tone of the meeting is always positive and upbeat. It is a pleasant experience.

If you ever find yourself at a loss for topics at a meeting try asking employees to tell you about a problem that occurred recently in their area of the office. Or ask about incidents that made patients unhappy. Employees often try to protect the doctor from these incidents, but you really do want to know.